How often do you find yourselves perplexed at the bad breath from your mouth despite following all instructions and brushing regularly? There are some bacteria that even the best of the toothpaste cannot get rid of.

This is why supplementary mouth cleaning agents are needed. (1) Chlorhexidine gluconate mouthwash is an oral rinse which is recommended by dentists globally. It has many benefits like its antiseptic nature and ability to manage gingivitis, foul smell, and other oral infections.

However, there are several side effects of chlorhexidine mouthwash such as staining of teeth and restorations, mouth irritation, sore throat, etc.

What is chlorhexidine gluconate?

Abbreviated as CHG, chlorhexidine gluconate is a chemical antiseptic and disinfectant. It acts by the binding of its positively charged ion chlorhexidine with the negatively charged ions of the bacterial cell.

At low concentrations, it’s effect is bacteriostatic which means chlorhexidine inactivates bacterial activity. At high levels, it is bactericidal which means it kills the bacteria.

Uses of chlorhexidine mouthwash

  • If you have swollen gums with bleeding and a foul smell from the mouth, your dentist will advise you mouth rinses two or three times a day. Chlorhexidine rinses help to get rid of the bacteria in the gums, supplementing tooth brushing and scaling.
  • Rinsing the mouth with CHG reduces the inflammation and helps the gums to return to the healthy state.
  • It is also effective against fungal infections like oral thrush.
  • Chlorhexidine is also prescribed by dentists after periodontal surgery, to promote faster healing. (2)

Chlorhexidine Gluconate Mouthwash infographic

Usage of chlorhexidine gluconate mouthwash

You must use chlorhexidine gluconate oral rinse as prescribed by your dentist. Usually rinsing twice a day is recommended. The measuring cups that come with the mouthwash tell you the dosage required.

Take the prescribed quantity of the mouthwash in your mouth, swish it for thirty to forty seconds, and spit it out.  You must make sure you don’t swallow the mouthwash.

As an alternative to the mouth rinse, chlorhexidine is also available as a chip. If you have a deep pocket in your gums, the dentist places the chip in these pockets and replaces them periodically. (3)

Side effects of chlorhexidine mouthwash

While this mouthwash has antibacterial properties, it also has a range of side effects. Many clinicians do not recommend using chlorhexidine gluconate. Here’s why-

  • Numerous studies show that chlorhexidine kills even the beneficial bacteria from the mouth. There are special bacteria that produce nitric oxide. Nitric oxide is a chemical that we need to keep our blood pressure in check. But chlorhexidine destroys this bacteria, consequentially affecting the nitric oxide levels in the body.
  • Cytotoxic levels of chlorhexidine are high. This means that it is poisonous for our cells and eventually causes slow cell death in the gums and alveolar bone.
  • The most common side effect of chlorhexidine mouthwash is tooth staining. It is known to cause brown stains on the teeth. Not just natural teeth, artificial crowns are also affected by staining. (4)
  • If used in higher concentrations, it can cause mouth irritation and sore throat. (5)
  • The mouthwash may also cause alterations in taste sensation and a dry mouth. You may also experience unpleasant taste. For some users, the change in taste sensation can become permanent.
  • Mouth ulcers or itching because of rinsing is another side effect of chlorhexidine gluconate.
  • Tartar also forms in the mouth after continuous use of the mouthwash, which is contradictory to its actual indication.

If you develop a severe allergic reaction to the mouthwash, you will experience swelling of the lips, tongue and the lower half of the face.

Precautions

  • Although there is no known effect of chlorhexidine on pregnancy, it is essential to inform your dentist if you are pregnant and he prescribes mouthwash.
  • Similarly, lactating mothers should also inform the dentist, as there may be unforeseen drug interactions. It remains unknown if the drug passes through breast milk.
  • If you have any known allergies to any medicines or chemicals, inform your dentist when chlorhexidine is prescribed to you.
  • The mouth rinse should not be given to children in the adult dosage and without any supervision or medical advice.

The treatment regimen for gingivitis

Other than rinsing, gingivitis requires an extensive treatment regimen to improve the overall condition of your gums.

  • Scaling and root planning is a procedure performed by your dentist to remove plaque and calculus around and beneath your gums. This helps to eliminate the bacteria causing the infection.
  • You must maintain oral hygiene as explained by your dentist. Brushing twice daily and flossing as required help to do so.
  • Habits like smoking, tobacco chewing worsen the gingivitis. Hence habit cessation should be employed.
  • Your diet should have a balance of all nutrients, and you must keep a check on eating sugary and acidic foods.

Over to you on chlorhexidine mouthwash

Chlorhexidine gluconate mouthwash is a useful aid in the treatment of mouth infections. It is commercially available under different brand names and combinations. You must take it only as prescribed by your dentist.

You may have to use it regularly for best results. Not to forget that it is no replacement for other essential mouth cleansing options such as daily brushing, flossing, etc.

Chlorhexidine gluconate mouthwash is an oral rinse recommended by dentists. It has antiseptic property & fights gingivitis, foul smell, etc.